RCHC Community Project Abstracts

Back to preceptor site search page or search by subject

Prevalence of HTN in the Pt population seen by a Clinician at the PFMC and Patient’s Attitudes towards Management of HTN
Date of project: 4/27/2009

About 29% of US population has high blood pressure and only 54% of these patients are on anti-hypertensive treatment, and only 33% of these pts on treatment have good control (1). HTN is associated with a high morbidity and mortality. Even though pharmacologic treatments have shown promising results in managing HTN, the side effects, the cost, and pt’s attitudes towards taking medications limit their use in successful management of HTN. As I was doing my rural rotation, I noticed that almost a third of the pts had HTN and so I decided to do this project to determine the prevalence of HTN in this population. I was also curious to find out what patients (with/without HTN) think is the most important factor in managing a high BP.

Only YOU Can Prevent Colorectal Cancer The Prevalence of Colorectal Cancer Screening at Philomath Family Medicine
Date of project: 9/8/2008

Colorectal cancer (CRC) is the third most common type of cancer and the second most common cancer killer in the United States. As a result, an effort is being made to emphasize screening for colorectal cancer to find it before it starts. The methods that are now recommended that can detect pre-cancerous lesions are colonoscopy and flexible sigmoidoscopy with fecal occult blood testing (FOBT), and only FOBT. I was concerned that in a smaller town such as Philomath, OR that these new recommendations may not be in practice. Through my observation of physicians in the practice I was at I saw that indeed these guidelines are in practice. I also did a chart review to get a feel for how many people have been screened for colorectal cancer and if so which methods they used. Eighty patients ages 50 and older were investigated via chart review or direct questioning and it was found that 68 had been screened for CRC and 12 of them had not. The most common method chosen for CRC screening was colonoscopy. Patients who had not been screened were contacted and asked if they would be willing to state the reason they had not been screened for colorectal cancer. Reasons included cost, lack of insurance coverage, lack of doctor visits, lack of discussion with physician, or simply they have not wished to be screened. A brochure explaining the importance of CRC screening and the methods available for screening was sent to patients who had not been screened.

Mental Health Care Practitioners in Philomath, OR: Difficulties with access and availability.
Date of project: 4/28/2008

The supply of both prescribing mental health care providers as well as licensed therapists in rural settings in the United States is a major problem. Subsequently, there is a significant shortage of available providers to see patients in a timely manner. Although many primary care physicians, such as family medicine doctors, are capable of supporting and treating many patients with psychiatric problems, most lack both the time necessary to engage in meaningful therapy as well as the skill set required to manage acute mentally ill patients well. For these reasons this project was developed in order to better characterize the local deficiencies in mental health care services and access as well as to offer a potential solution by generating a viable list of providers in the area that are accepting new patients. A general consensus within the Philomath Family Medicine clinic indicated a shortage of rapid access to prescribing mental health care providers was present and that more providers were needed in the area. A provider list was generated four years earlier through a similar project, although many of the physicians, counselors, and therapists on that list were either no longer in the area, or they were no longer accepting new patients. The primary care physicians felt an updated list of social support structures (public and private), psychiatrists, counselors, and therapists in the area would be of value. Through the use of various resources, a thorough list was created and included such information as a description of the practice with areas of interest/specialization unique to the provider, the current waiting time to be seen, eligibility requirements, and payment structure.

An analysis of barriers to regular exercise and implementation of a patient handout in Philomath, OR.
Date of project: 9/10/2007

Benefits of exercise and increased physical activity are well documented. Despite this, many patients of Philomath Family Medicine (PFM) do not engage in regular exercise. At PFM the barriers preventing patients from engaging in regular exercise were assessed by interviewing multiple physicians within the practice, a local expert, and by patient survey. During observation of physician-patient discussions, physicians often lacked the time to thoroughly explore patients’ reasons for inactivity. A patient handout was created to stimulate self-reflection and provide education and motivation for how to overcome personal barriers.

Treatment of the prediabetic patient in a primary care practice. Study of the current practices of managing prediabetic patients in Philomath, OR
Date of project: 4/30/2007

Diabetes is a serious medical condition affecting 20.8 million children and adults in the United States, or 7% of the population. The diagnosis of diabetes has far reaching consequences including adverse effects on a patient’s kidneys, heart, eyes and nerves. There is growing evidence that a pre-diabetic states exists before the development of diabetes and that individuals in this state have the opportunity to prevent the disease through lifestyle changes in their diet and exercise regimens. The purpose of this project is to identify the prevalence of a population at high risk for diabetes, to assess current methods of diabetes prevention through interviews with family practice doctors and to develop effective patient education materials, which will help to teach patients methods to modify their risk for developing the disease. Education will be focused on lifestyle modifications with the goal of preventing the development of type 2 diabetes. Future projects may assess the effectiveness of these materials by long term follow up of the identified patient population and their propensity for developing diabetes.

Increasing awareness of opportunities for social interactions and physical activity for senior residents of Philomath, OR
Date of project: 9/11/2006

Numerous studies have demonstrated the benefits of maintaining social interactions and engaging in physical activity for elderly people. These include an increased sense of independence, improvements in quality of life and general functioning, an increase in measures of mental health functioning, as well as lower rates of obesity, diabetes, osteoarthritis and cardiovascular disease. I sought to catalog resources in the community for opportunities for social interaction and physical activity and to overcome the barriers of cost and transportation to encourage utilization of these resources. I then designed a large color poster to encourage awareness of local opportunities, printed 30 smaller color handouts for seniors to take home, and compiled an informational binder to be housed in the waiting room at Philomath Family Medicine.

Sex Education in Philomath, Oregon: What is the message and is it getting across?
Date of project: 9/12/2005

Teen pregnancy and sexually transmitted infection (STI) rates are important indicators of issues affecting the health and future prospects of our country's youth. This project attempted to look at the sexual education provided to students at Philomath High School to help them make the decisions affecting these rates, and compare this to programs used nationally. It researches the specific components of the high school curricula, then, by means of a questionnaire, evaluates how the Philomath specific education translates into the knowledge and attitudes of the students it serves. Finally, using available data, it looks at how Philomath compares at a national and state level regarding teen pregnancy rates and rates of sexual activity. Data collected on the Philomath School District sexual education was obtained by interviews with the school nurse, high school counselor and the high school health teacher.

Alcohol Misuse in Benton County
Date of project: 4/25/2005

Alcohol misuse is strongly associated with health problems, disability, death, accident, injury, social disruption, and violence. In the United States, alcohol abuse generates nearly $185 billion in economic costs. In general, alcohol misuse is under diagnosed by the primary care physician. The purpose of this community project is to assess the magnitude of the problem of alcohol misuse in Benton County, methods of detecting alcohol problems in our patients, examine the most successful treatment programs for achieving and maintaining sobriety, and the availability of alcohol treatment programs in Philomath, OR and Benton County.

Employee Wellness At The Corvallis Clinic
Date of project: 3/21/2005

Philomath Family Medicine is part of the Corvallis Clinic which employs 570 people in 3 clinics. Over the past year, several employees have mentioned their interest in company-sponsored fitness programs and activities. Many people working at the Corvallis Clinic feel that obesity is a major problem among employees in their organization. While informal walking groups and weight loss support groups exist, there is no explicit program in place to help employees maintain their health. This project was created to explore the possibility of creating a wellness program for Corvallis Clinic employees. This project focused on three things: 1) Assessing a local wellness program already in place at Samaritan Health Services (not affiliated with the Corvallis Clinic) 2) Gathering information on interest, ideas, and feasibility of a wellness program for the Corvallis Clinic 3) Making recommendations for a wellness program at the Corvallis Clinic

Philomath Pertussis Outbreak
Date of project: 2/7/2005

The number of cases of pertussis has been steadily increasing during the last several years nationally and also in Oregon. Benton County has lead the state during the last year with the help of two outbreaks including a focus in Corvallis during spring and a recent outbreak centralized in Philomath during fall/winter of 2004. The incidence rate has reached 1250/100,000 in Philomath and has overwhelmed the County Health Department along with the rest of the health care system. To deal with the recent epidemic the health department has decided to change its policy concerning chemo prophylactic usage and to recommend antibiotics use only to asymptomatic contact in high risk-groups. This policy change will allow a more careful use of antibiotics and a stronger focus on groups that are more susceptible to complications such as infants, pregnant women and elderly. Through time spent collecting data at the health department, multiple interviews with various people who are involved at different level of the epidemic and my own experience assisting with taking care of patients with pertussis, I have developed a better understanding for how outbreaks are handled by a health system. During my investigation into the outbreak I realized that high school students had a high incidence rate and tended not to understand much about the disease. I made a video with several high school students that was played during school that gave basic information about pertussis, gave them reasons why the disease could be important to them and taught them some ways of decreasing its spread. I also made signs that are posted throughout the school which gave similar information. In addition, I made a handout for the family medicine clinic that I was rotating in that covered the most frequent questions that patients ask about pertussis in order to assist the staff and provide information to the patients in a quick, informative manner.

The Use of Flexible Sigmoidoscopy in a Rural Family Medicine Clinic
Date of project: 1/3/2005

Colorectal cancer is a largely preventable and yet prevalent cause of mortality in the US. Accordingly, professional organizations with published guidelines for screening recommend that all adults ages 50 or older receive screening for colorectal canter (1). Of the screening options available, colonoscopy is the most sensitive and specific test for detecting colorectal cancer (2). However, in many rural areas there is a shortage or even absence of colonoscopists. In one such town, Philomath, physicians at a family medicine clinic are working to fill this gap in cancer screening. Eligible patients of this clinic are actively encouraged to get screened via yearly fecal occult blood tests and flexible sigmoidoscopies once every five years. The sigmoidoscopies are performed in the clinic by the family physicians. This study assesses patient records of one of the Philomath physician's positive scope findings over the past five years. In evaluating follow-up colonoscopy and polyp biopsy results on these patients, it will be shown that flexible sigmoidoscopy is a useful tool in colon cancer screening. Not only can flexible sigmoidoscopy identify patients with polyps who are at higher risk for developing colrectal cancer, thereby helping to reduce the burden on limited colonoscopy resources, but it may also provide reassurance to those with negative findings.

Mental Health: Breaking Down Barriers to Mental Healthcare in the Philomath Area
Date of project: 10/18/2004

Mental illness is common across America and this may be most apparent in primary care clinics. Primary care physicians have become a significant focal point to mental healthcare delivery everywhere, but especially in rural communities where community mental health resources are lacking. This report assesses the prevalence and disease burden of mental illness in the U.S. overall, in our rural communities, and in Benton County. Secondly, it discusses the barriers to mental healthcare and the role of the primary care physician for mental healthcare delivery. Thirdly, it evaluates the community mental health resources available in the Philomath-Corvallis area, as well as how the physicians of Philomath Family Medicine are utilizing these resources. Finally, from the information gathered by survey of the community, and physician and therapist interviews, a consolidated list of community mental health resources was produced, including contact information, description of services, eligibility and cost. The ultimate goal is that these lists will promote more effective utilization of community mental health resources in the Philomath area.

Pedometers as Motivational Tools to Increase Physical Activity in Philomath Oregon
Date of project: 9/13/2004

Physical inactivity has been identified as one of the top contributors to obesity. Combined with poor nutrition, it is the second highest preventable cause of mortality. In preliminary studies, pedometers have been shown to be a potential motivational tool to increase physical activity. The purpose of this study is to investigate the effects of a 7-day, pedometer-based lifestyle physical activity intervention. Participants were 10 patients from Philomath Family Clinic who volunteered to participate in the study. Participants’ perceived physical activity and actual physical activity was measured through questionnaires and by wearing a pedometer while doing typical activities. Questionnaires also examined patients’ motivation, environmental barriers, and knowledge of exercise. After completion of the 7-day trial, participants are asked to reflect on their activity level and their experience with the pedometer. Results indicate participants averaged 14,754 steps per day. Preliminary, findings from this study demonstrate that pedometers encourage most participants to want to increase their activity level.

Exercise in the Elderly in Benton County
Date of project: 8/9/2004

Exercise in the elderly (>65 yo) has tremendous benefits for cardiovascular disease, diabetes, osteoporosis, osteoarthritis, neuropsychological health, and cancer. Philomath presented a challenge in mobilizing elderly for exercise with few facilities for exercise. The first part of this project was to discover if people were exercising and were they exercising enough. Secondly, to discover the types of exercise people were doing and their motivation to exercise. Lastly, with that data, mobilize the population to exercise. A survey was used at Fitness over 50 and philomath Family medicine to look at amount of exercise, motivation for exercise, types of exercise and barriers to exercise. The owner of Fitness over 50 was interviewed to understand his unique model and meeting attended at city hall to learn about a future Senior Center. The exercise group averaged 3.9 days of exercise a week at 53.4 minutes a day and the Philomath group averaged 3.3 days a week at 35.9 minutes a day. This data suggests that the population not exercising doesn't come to the physician's office frquently for annual checkups. Therefore in oder to reach the population, prevention has to extend beyond the clinic. With the data an exercise "prescription" was formulated to hand out to patients.

"Keeping Coughing Kids Home": A Description and Analysis of the 2004 Pertussis Epidemic in Benton County.
Date of project: 5/10/2004

The national incidence of pertussis has gradually increased over the past several years. Since 2003, Oreogn has gained national attention as the incidence of pertussis appeared to increase at an alarming rate to a 40-year high for the state. Adults and adolescents are believed to be the primary reservoir for the bacterium whereas the disease causes the most morbidity and mortaility in infants less than 1-year-old. Benton County currently has one of the highest numbers of reported cases of pertussis in 2004 in the state. This study sought to provide a descriptive analysis of the current trends of this vaccine-preventable illness in Benton County using the most current data provided by the Benton County Health Department (BCHD) as well as an interview with departmental personnel to discuss the public heatlh measures undertaken to reign in the epidemic. The data from BCHD revealed that the majority of cases were school-associated 92% and occurred in the Corvallis school district with 34.2% of the cases occurring in Corvallis High School primarily between 3/14-4/11/04. Community physicians were responsible for treating both confirmed and presumptive cases (total 110) in addition to lowering the antiobiotic prescribing threshold for upper respiratory tract infections with a protracted cough. The BCHD has responded to the epidemic by regularly communicating with schools and parents. The department has many interventions planned during the anticipated peak months of the epidemic this summer. It is unclear whether the increased number of reported cases is simply due to increased surveillance or more disease, but is likely a combination of both.

Emergency Contraception: Knowledge Among and Attitudes at Philomath Family Medicine
Date of project: 3/29/2004

Unplanned pregnancy is a major medical, social and public health issue. In the United States, unintended pregnancies account for approximately one half of the 6 million annual pregnancies. These unintended pregnancies result in an estimated 1.4 million abortions and 1.2 million unplanned births each year. Despite better and more effective contraceptive tools, these unintended pregnancy rates persist. Research has demonstrated that emergency contraceptive pills (ECPs) are safe and effective in preventing intended pregnancies. However, for emergency contraception (EC) to be effective women need to know that it exists, how to use it, and be willing to use it. This project was conducted to assess both the awareness of and attitudes toward emergency contraception among female patients and health care providers at Philomath Family Medicine. Data was gathered through the use of two separate surveys: one for patients and a second for providers. Among the 36 women who completed surveys, the majority, 97%, had heard of emergency contraceptive pills, but 17-56% lacked at least one key piece of knowledge about emergency contraceptive pills that may preclude effective use. Additionally, among the 6 health care provider surveyed, all described themselves as at least somewhat familiar with emergency contraceptive pills and all had prescribed them in the past, 5 out of 6 had prescribed them in the past year.

Intimate Partner Violence Resources in Benton County: Needs Assessment and Development of Patient Education and Physician Intervention Tools
Date of project: 1/5/2004

With a lifetime prevalence of one in ten, intimate partner violence (IPV) is the number one health threat to women in the United States today. This study explored the resources available to abused women in Benton County and sought to optimize physician IPV intervention at the Philomath and Corvallis Family Medicine clinics by developing a reference tool for recognition, screening, management, and referrals. The design included interviews and observations of physicians, nursing staff, and patient advocates, interviews and tours of community resources, telephone interviews with the district attorney, county sheriff’s office, and Benton County Health Department, and research on visibility of community resources via phone book, patient outreach materials, and online sources. As patients were not universally screened for IPV, a patient education poster with crisis line numbers was designed for use in all exam rooms. Further, physicians indicated a need for a concise reference guide for IPV screening and intervention in Benton County. Thorough review of online and community resources revealed no such tool; thus, this project culminated in the development of a laminated exam-room card listing Benton County IPV impact and statistics, effective screening techniques, management of disclosed abuse, mandatory reporting, legal rights of IPV victims, and further resources for physicians. Finally, a Center Against Rape and Domestic Violence presentation was organized to further physician education regarding effective IPV screening, intervention, and community resources. By implementing IPV patient outreach and physician intervention tools for practical use, I sought to streamline the coordination of care between community resources, physicians, and their patients.

Prevalence of Overweight Among Philomath Children, Fall 2003
Date of project: 9/29/2003

Obesity is an increasing problem in the country’s adult and youth populations. Among adults in the United States, the prevalence of obesity increased from 13% to 27% between the years 1976-1980 and 1999. The problem is as substantial in the youth population. The prevalence of overweight among children aged 6-11 has increased from 4% to 15.3% between the 1960s and 1999-2000. This community project studied the data of 370 school children in Philomath, OR from grades kindergarten through 6th. Each child’s Body Mass Index (BMI) was calculated to assess the prevalence of overweight and at risk in Philomath’s youth population. It was found that only 66% of Philomath’s youth are normal weight, 16% are considered at risk, and 18% are overweight (data categorized using the CDC’s growth charts for children). The overweight problem needs to be addressed, most likely by parents and by schools. A less sedentary lifestyle as well as nutritious and moderate food consumption should be promoted.

Home Health Care Options for Seniors in Philomath, Oregon.
Date of project: 11/10/2003

Benton County is a community of 78,00 people with about 12% being over age 60. There are multiple nursing homes and hospice facilities available for those who need it, but there is a large population of seniors who choose to stay in their homes. Benton County is a rural community and many seniors live in isolation with few neighbors and sometimes no family. Some of the people who remain in their homes require daily medical services such as medication management, insulin injections, or wound care. More often though, they just can’t get around as well as they used to and need help with basic house keeping or meal preparation. These types of services can be managed on an outpatient basis, saving the patient and taxpayer money and allowing seniors to maintain their autonomy as long as possible. Although there are many home health services available in Benton County, not all physicians and patients are aware of them. My project was to organize all of the options for home health care into one report with some basic information about all of them, such as how they are funded and the services they offer.

Incidence of E. coli 0157 in Benton County and Oregon
Date of project: 8/18/2003

The CDC emerging Infections Program employs an active surveillance network (FoodNet) to monitor state trends in major foodborne illnesses. E. coli O157 is one of the pathogens monitored, which has not had a consistent decline from 1996-2002. This project is an assessment of the annual incidence of E. coli O157 infections in Benton County and Oregon during the past decade. 2002 incidences for Benton County and Oregon are compared with national values. Data searches were conducted in electronic data collections of CDC's MMWR, FoodNet Annual Reports, and Oregon Department of Human Services Annual Reports. It was found that in the past ten years, Benton County has had a sustained decline in E. coli O157 and has had similar rates as the national rate. Oregon overall has had fluctuations in E. coli O157 incidence and has been consistently above national rates for the past ten years.

A Philomath Senior Center * Wellness Program *
Date of project: 7/7/2003

Abstract: Many communities have developed senior centers to serve the diverse needs of their elders. They are as varied as the communities and seniors that they serve. Senior centers help keep older people active, healthy and independent while strengthening the web of relationships between individuals and their communities. Many, many types of activities and programs are available at senior centers, depending on the local context, needs and interests. These include health and wellness programs such as support groups, informational talks, and various clinics. The level of programming varies considerably. Philomath presently has no senior center, but a group of local people is working to change this. They hope to restore the historic College of Philomath building and have proposed this as a home for a local Philomath Senior Center. The project is just in the beginning stages but energy is gathering for addressing the questions and doing the work. They would join thousands of other communities who have developed and maintain a local senior center.

A Survey of Awareness and Practice Regarding Preventive Measures Against Mosquito-borne Disease in Philomath, Oregon.
Date of project: 5/5/2003

The West Nile virus, responsible for West Nile fever and viral encephalitis, is expected to arrive in the Pacific Northwest for the summer of 2003. This anticipated event provides the healthcare community with a rare opportunity to educate the public about a disease prior to its occurrence in the community. Historically, vector control and personal protective measures have been shown to be one of the most effective approaches to minimizing the impact of vector-borne diseases. Understanding the current state of knowledge regarding these practices is a useful step in preparing educational material, for both healthcare recipients and providers. A self-selecting, self-administered anonymous survey was conducted with 109 patients at a Family Medicine clinic in Philomath, Oregon. Awareness of preventive measures, as well as actual performance of those measures, was queried, in addition to the gathering of demographic data. A secondary benefit was the passive education of the study participants, via the survey-taking process. The results demonstrate a high level of awareness of preventive measures (72%), despite a moderate level of implementation of those same procedures (55%). The provision of education material to patients as well as care providers would likely assist in achieving a greater level of compliance with preventive measures against vector-borne disease.

Rural Hospice Services in Benton County: A description of available services.
Date of project: 3/24/2003

Hospice cares for 25% of deaths in the US. This project sought to explore hospice services available to a rural Oregon population. What is the patient population of rural hospice? What challenges does a rural hospice provider face? To answer these and other questions, the patient population of Benton Hospice, Inc., the predominant hospice provider in Benton County, was used. Home visits and nursing home visits were made with a hospice nurse, a team meeting attended, and volunteer coordinator and coordinator of patient services were interviewed. Data provided by Oregon Hospice Association of Benton Hospice allowed for comparison of statistics between Benton Hospice and Oregon state hospice populations. Results of this study revealed that Benton county hospice patients have available a wide range of services including hospice nursing, PT/OT, social work, and home health aides. Additionally, volunteer contributions are significant including massage therapists, music therapy, pet therapy, and life's history services. Benton hospice workers and administrators cite several benefits to a rural hospice program while acknowledging challenges.

Resources for parents in Philomath, Oregon: development of a patient handout for supplementation of office visits
Date of project: 2/10/2003

Parenting issues are not uncommon in primary care. This study attempted to investigate how these issues were handled in a Philomath, Oregon family practice clinic. Family physicians in this clinic were observed in these circumstances. Although physicians were adept at dealing with these issues, it was noted that a handout summarizing some helpful resources for parents would be beneficial. This handout was created using local resources as well as resources available on the internet.

Benton County Hospice: Description of an Available Program
Date of project: 11/4/2002

My goal was to study Benton County Hospice and their provisions of end-of-life care services to the community. I chose this topic after being introduced to the Philomath Family Medicine Clinic and realizing that the patient population includes a significant number of senior citizens. Because there is a correlation between advanced age and increased incidence of terminal illness, Philomath Family Medicine Clinic physicians often have patients admitted to Benton County Hospice. My methods to learn more about Benton County Hospice included: meeting with personnel, attending meetings, and visiting patients with a hospice nurse. Through these activities I successfully gained insight to Benton County Hospice and its vital role in the community. In addition, I came up with suggestions on how the hospice might disperse excess funds.

Adult Foster Homes in Philomath, Oregon. A survey of services offered, population served, and the licensing requirements of these institutions.
Date of project: 9/23/2002

With the aging of our population comes an increasing need for more long-term care facilities. Adult foster homes (AFH) were spawned from the need for facilities that could provide quality care in a less institutionalized setting at a reasonable cost (about two-thirds the cost of nursing home care). Philomath is a small town of approximately 4,000 inhabitants, which is located in Benton County. Benton County has a population of 77, 929, 10.3 % (8026 individuals) of this population is 65 or older. There are two adult foster homes in Philomath, His House and Heaven's Half Acre. The goals of this project were to first identify what role these adult foster homes play in Philomath and the surrounding communities, to understand the services offered and to finally identify licensing and requirements for licensure. These goals were met via interviews with the Benton/Linn County AFH licensor and with the providers at the homes in Philomath. The findings of this study illustrate that AFHs provide long-term care to those with Activities of Daily Living (ADL) impairment. The homes in Philomath serve primarily the elderly (65 and older) and, occasionally, younger disabled individuals from Philomath and its surrounding cities. There are three levels of AFH, which provide progressively higher acuity of care. His House is a level III AFH and Heaven's Half Acre is a level II AFH. Adult foster homes must comply with regulations formulated by the state legislature, which are enforced through the local Senior Services Division in Albany by the AFH licensor Colleen Susac. Through the interviews conducted some gaps were identified in the services offered by adult foster homes, these are discussed throughout the paper.

Managing Your Diabetes: A blood glucose diary and educational brochure designed for education, motivation and improved utilization of the 15-minute appointment
Date of project: 8/12/2002

Diabetes Mellitus (DM) is a serious and potentially deadly syndrome that affects 6.2% of the United States population. It is also a financial burden. The estimated cost of annual medical care for diabetics (direct costs) is $100 billion. Fortunately, it is also controllable. Through observation of family physicians, nurses, and diabetic patients, at Philomath Family Medical Practice, three issues fundamental to diabetes management were identified: 1) time limitations (15-minutes) of the diabetic appointment 2) education 3) motivation/morale. Both a blood glucose diary and an educational brochure were developed to try and address these three issues.

Understanding the patient behind the cigarette: A glimpse on smoking from the patient's point of view.
Date of project: 7/1/2002

Smoking is a risk factor for the four leading causes of death in the United States, yet 24% of the adult population continues to smoke. Furthermore, studies show that only 21% of American physicians feel that they have received adequate training to help their patients stop smoking. This combination has deadly consequences. In order to assist patients in smoking cessation, a physician must possess factual knowledge, as well as an understanding of the patients being treated. Knowledge can be easily obtained from books and journal articles. Understanding a patient’s point of view, however, is only achieved by asking the patient. This study attempted to gain a greater understanding of the smoking population in the Philomath Family Clinic. The design was a tobacco survey placed at the front desk, and offered to patients as they arrived for their appointments. Completed surveys were collected for three weeks, at which point the information was analyzed. Information was also gathered from the internet regarding recommendations for physicians who treat patients who smoke. Pocket-sized cards containing these recommendations were created to be distributed to colleagues.

The Skinny on Losing Weight: Obesity and Treatment Recommendations for Adults at Philomath Family Medicine Clinic
Date of project: 3/25/2002

According to the most recent national surveys, overweight and obesity have become an epidemic in the US. The health risks associated with obesity are enormous including hypertension, diabetes, dyslipidemia, non-alcoholic steatohepatitis and sleep apnea. An information survey of patients at Philomath Family Medicine clinic showed that overweight and obesity are significant problems. 61% of adults between the ages of 18 and 63 are either overweight or obese: one third are overweight while 28% are obese (BMI>30). The combined prevalence of overweight and obesity (BMI>25) is 62% in women and 60% in men. This is consistent with recent US national population surveys from the CDC. Although a majority of those who are at least overweight reported having a discussion of the dangers of obesity with their doctors, only a handful received guidelines on how to effectively and safely lose the weight. The goal of this community project is several fold: 1) to assess the nature of the problem with obesity at Philomath Family Medicine clinic, 2) to formulate recommendations for managing and treating obesity and 3) to develop a patient education handout on healthy approaches to losing weight.

Weight Loss Success: A Local Guide to Resources.
Date of project: 5/6/2002

Obesity has become a serious health issue in the United States. The population of Philomath and Corvallis, both located in the mid-Willamette Valley in Oregon, is no exception. In response to the lack of awareness of local resources for sufferers of weight loss issues, a local guide was created to increase the general population?s knowledge of this critical issue, as well as assist individuals mentally and medically. A brochure was constructed to warn them of the dangers of obesity, to inform individuals of the benefits of weight loss, and to inspire and spark an interest in the many exercise and nutritional programs available in the area.

Establishment of a Coumadin Clinic in Philomath, Oregon.
Date of project: 11/5/2001

Warfarin is a commonly prescribed anticoagulant medication with a narrow therapeutic range. Patients on chronic warfarin therapy must have frequent blood tests to monitor the effects of the medication. Traditional warfarin monitoring requires a monthly venipuncture and a follow-up phone call from the physician to make medication adjustments. Anticoagulation clinics (Coumadin clinics) are increasing in popularity and provide instant blood test results and dosage adjustments with a drop of blood out of the fingertip. Philomath Family Medicine manages the anticoagulation for 45 patients on chronic warfarin therapy and will be opening a Coumadin clinic in January, 2002. The majority of patients surveyed indicate that they are interested in utilizing the services of a Coumadin clinic.

Improving The Quality Of Life For An Aging Population: An Analysis of the Accessibility and Availability of Services for Seniors in Benton County, Oregon.
Date of project: 9/24/2001

Almost 13% of the population in the United States and 10.3% of the population in Benton County is over the age of 65. Studies predict that the 65+ age group will grow by 135%, while the number of people who are 85+ will grow by 401% by the year 2050. With this incredible rate of growth, the demands on society to develop specialized services that provide assistance for the elderly are profound. The needs of the elderly are extensive and include assistance with the activities of daily living, housing, transportation, nutrition, health care, social interaction, financial assistance, support groups, and end-of-life care. The purpose of this project was to analyze the availability, accessibility, quality, and use of services provided for seniors within Benton County, Oregon. The results of the study show that there are many, high quality services within Corvallis. These services appropriately address many of the needs of seniors and most of the services have an excellent rate of participation. However, several areas of weakness were also found that may prevent many seniors from accessing these services. These included the lack of a central resource agency, extremely high costs for many of the services, lack of an adequate transportation program, lack of adequate resources in rural communities surrounding Corvallis, and a limited number of resources for individuals who do not have a high level of function. If these areas are not addressed, the pressure of the aging population on Benton County may prevent many seniors from receiving a number of services that are required to provide dignity, respect, and a high quality of life.

Prevalence of Diabetes Mellitus at the Philomath Family Clinic.
Date of project: 8/13/2001

This study sought to determine the prevalence of diabetes at the Philomath Family Medical Clinic, a single-site provider clinic served by five physicians. The design is a chart review of the patient encounters for the year from August 1, 2000, to August 1, 2001. Outcomes were measured by ICD-9 codes reported for patient visits. Out of 5381 patients seen, 240 carried a diagnosis of diabetes. The report compares diabetes prevalence for this population against national and statewide estimates and suggests directions for future lifestyle interventions for this population.

Back to preceptor site search page or search by subject